Health Canada Drug Abuse.pdf

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Health Concerns

Straight Facts About Drugs & Drug Abuse

Table of Contents

The Charts

The following pages contain a series of charts with detailed information on specific drugs. Eachchart represents a different group or family of drugs. Each individual drug within a group is

described by its physical appearance, its origin and medical uses, its short-term effects, its long-

term effects, its addictive properties and its legal status. Each drug is listed by its common

designation (for hallucinogens and cannabis preparations) or its generic name (for other drugs), in

bold face type. Where a common designation is used, it is followed by the drug's chemical name.For drugs marketed as (or in) prescription products, the generic name is followed by at least one

widely recognized example brand name indicated by the symbol "". Finally, where relevant,some popular street names are given in italics.

Eight of the nine charts deal with distinct groups of drugs. These are sometimes calledpharmacological (farm-a-ko-logical) drug groups. The word "pharmacology" means the study of

drugs. It comes from the Greek words pharmakon (drugs) and logos (study).

Anabolic steroids are included because of both their use for enhancing performance or changing

body image, and their psychoactive effects. It should be noted that national and international

sports bodies have also banned many other types of drugs such as stimulants, cannabis, and CNSdepressants from use in sports.

1. Hallucinogens

Hallucinogens are drugs that dramatically affect perception, emotions and mental processes. Theydistort the senses and can cause hallucinations-sensory images similar to dreams or nightmares.

Hallucinogens are sometimes called "psychedelic drugs". They are most often used for their so-

called "mind-expanding" effects. The best known and most frequently used hallucinogen is LSD.

There is no currently accepted medical use for hallucinogenic drugs, although in the past LSD andsome other hallucinogens were used experimentally to treat some psychiatric disorders. Use of

some hallucinogens, particularly MDMA "Ecstasy", has become popular in the dance scene and at

raves. Accidental deaths due to hyperthermia (overheating) and dehydration (fluid loss) haveoccurred among young people from use of Ecstasy.

2. Central Nervous System Depressants

Included in this category of drugs are opioid analgesics, alcohol, inhalants, benzodiazepines,barbiturates and other sleeping pills.

Central Nervous System (CNS) depressants are drugs that cause a slowing down or depression ofthe central nervous system. At low doses, they produce a feeling of calm, drowsiness and well-

being. At higher doses, some CNS depressants can produce severe intoxication, unconsciousness,

coma and death.

When more than one CNS depressant is present in the body at the same time, their effects may

be dangerously intensified. Alcohol and barbiturates are an example of a particularly dangerouscombination.


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Regular use of CNS depressants can result in physical and psychological dependence.

Opioid Analgesics are highly addictive painkilling drugs that may also produce an extreme sense of

well-being. Some are natural drugs that come from the opium poppy; others are synthetics

produced in laboratories. When opioid analgesics are taken with other CNS depressant drugs, theeffects are intensified and can result in death. Opioids, such as morphine, meperidine, and

methadone, have valuable medical uses, but should only be used under medical supervision.

Because the abuse of opioid analgesics poses serious personal and social problems, these drugs

are under the strictest legal control.

Alcoholaffects the central nervous system in similar ways to other depressant drugs, producing

relaxation and disinhibiton at low doses, while at higher doses, producing intoxication, impairedjudgment and coordination, and at very high doses, coma and death.

Alcohol is found not only in beer, wine and liquor, but also in some commonly used liquid, over-

the-counter medications and products.

Inhalants (also known as volatile solvents) are depressant drugs that produce feelings of euphoria,

light-headedness, exhilaration and vivid fantasies, and also slow down body functions such as

breathing. Their use can result in brain damage, asphyxiation and death.

Because they can be sniffed or inhaled, these substances are known as inhalants. They are alsoknown as volatile solvents because they evaporate when exposed to the air (volatile), and asliquids, they dissolve many other substances (solvents).

Inhalants can be categorized as solvents, gases or nitrites. Solvents include industrial andhousehold products such as cleaning fluids, glues, paint thinners and removers. Gases are found

as aerosol propellants in some paint, hair and deodorant sprays. Gases also include gasoline for

motor vehicles, lighter fluids and medical anaesthetic gases such as ether and nitrous oxide, as

well as the less commonly encountered vasodilator nitrites, amyl nitrite and butyl nitrite.

Benzodiazepines produce a sense of calm and well-being at lower doses. At very high doses, they

can cause effects similar to barbiturates, including unconsciousness. They are seldom fatal inoverdoses, except when mixed with other drugs. Benzodiazepines are commonly prescribed for the

management of anxiety, including panic disorders, for sleep problems, as muscle relaxants, for

control of seizures and to reduce symptoms associated with alcohol withdrawal. One of the mostwidely known benzodiazepines is Valium. Street names include: tranks, downers (a name also

used in reference to barbiturates), Vs (Valium).

Barbiturates are much less frequently prescribed today and have largely been replaced by

benzodiazepines. At low doses, they produce a feeling of calm, drowsiness and well-being. Many

barbiturates were first developed as sleeping pills. At higher doses, they can produce severeintoxication, unconsciousness, coma and death. When combined with another CNS depressant drug

such as alcohol, their use can be life threatening.

Barbiturates can produce severe dependence with regular use.

Top of Page

3. Stimulants

Stimulants are drugs that excite or speed up the central nervous system. They are generally usedfor their ability to increase alertness and endurance, to keep people awake for a long period of

time, to decrease appetite, and to produce feelings of well-being and euphoria. They have only

limited medical application. In Canada, they are used in the treatment of narcolepsy, attention-

deficit hyperactivity disorder (ADHD), Parkinson's Disease, and have had some very limited use inthe treatment of obesity. Stimulants can produce severe psychological dependence. The

psychological dependence produced by cocaine, for example, is believed to be among the

strongest of all drugs.


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Stimulants, including nicotine and caffeine, can produce physical dependence.

4. Cannabis

Cannabis, which includes marijuana (also spelled marihuana), hashish and hash oil, is presented ina chart of its own. It is the most widely-used of all drugs that are used illegally. Although basically

a hallucinogen, cannabis also produces depressant effects, as well as increased heart rate.

5. Antidepressants

Antidepressants are drugs used to treat clinical depression and some other disorders such as panic

attacks, obsessive compulsive disorders and bulimia. They are designed to elevate mood. There

are three types of antidepressants currently in use which all work in slightly different ways on the

central nervous system. Tricyclic antidepressants and Monoamine oxidase inhibitors (MAOIs) werefirst introduced in the 1950s. Tricyclic antidepressants have been the most widely used

antidepressant drugs. However, another class of antidepressants, Selective Serotonin Reuptake

Inhibitors (SSRIs), has been introduced more recently. SSRIs are now more commonly usedbecause they have fewer side effects. Despite their name, some antidepressants also have some

depressant properties and should not be used with alcohol or other depressant drugs.

6. Anabolic Steroids

Anabolic androgenic steroids belong to a class of drugs known as ergogenic or performance-

enhancing drugs. They include both testosterone and synthetic drugs related chemically to

testosterone. They are used primarily in veterinary medicine and in the treatment of a few human

disorders. Their use as performance-enhancing drugs became popular among some Olympicathletes as a way of improving muscle development and endurance. They continue to be used for

these purposes, (as well as to improve body image) although they have been banned by most

national and international athletic and sports regulatory bodies. They have the potential toseriously damage the person's health. It is also important to note that many other substances are

banned by national and international athletic and sports regulatory bodies.

Note: The next section illustrates some of the drugs that are most often used illegally. These

pictures are just examples. Drugs that are intended for medicinal use, such as antidepressants,

steroids and benzodiazepines are not included.

Anabolic Steroids

1

HALLUCINOGENS

2A

CNS

DEPRESSANTS:

OPIOID

ANALGESICS

2B

CNS DEPRESSANTS:

ALCOHOL &

SOLVENTS/INHALANTS

2C

CNS

DEPRESSANTS:

BENZODIAZEPINES

2D

CNS DEPRESSANTS:

BARBITURATES/OTHE

SLEEPING

PILLS/OTHER

PSYCHOTROPIC DRUG

CNS Depressant drugs are drugs that cause

a slowing down or depression of the central nervous system.

The term

"hallucinogen" (from

the Latin word

allucinari, meaning

"to dream, to wander

in the mind") is

applied to any drug

used to produce

distortions of reality

and hallucinations.

These drugs are

sometimes called

CODEINE

OPIUM

MORPHINE

HEROIN

(diacetylmorphine)

(diamorphine)

H, horse, junk,

smack

METHADONE

ALCOHOL

(ethyl alcohol or ethanol)

INHALANTS

(volatile solvents) sniff

Benzodiazepines

used primarily as

tranquilizers:

(anxiolytics)

DIAZEPAM

Valium

OXAZEPAM

Serax

LORAZEPAM

Ativan

Barbiturates/Other

Sleeping Pills

SECOBARBITAL

Seconal

reds, red birds, red devil

PENTOBARBITAL

Nembutal

yellow jackets

AMOBARBITAL

Amytal


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illusionogenic or

psychedelic.

PCP (phencyclidine)

angel dust, elephant,

hog

LSD (lysergic acid

diethylamide) acid,

blotter

MDA (3,4-

methylenedioxy-

amphet amine)

MDMA (3,4-

methylenedioxy-N-

meth ylamphetamine

or 3,4-

methylenedioxy-

metham phetamine)

Ecstasy, Euphoria, X,

XTC, Adam

MESCALINE (3,4,5-

trimethoxybenzene-

et hanamine) mesc

PEYOTE

(Lophophora) (3,4,5-

trimethoxyphenethyl-

a mine)

PSILOCYBIN (occurs

together with psilocin

in some mushrooms)

magic mushrooms,

shrooms

STP or DOM (2,5-

dimethoxy-4-

methylamp

hetamine)

PMA (paramethoxy-

amphetamine)

DMT (N,N-

dimethyltryptamine)

2CB or 2C-B or 2-CB

(4-Bromo-2,5-

dimethoxyphe

nethylamine or -desmethyl DOB

Nexus, bromo,

toonies, herox,

Synergy

o es

MEPERIDINE or

PETHIDINE

Demerol

HYDROMORPHONE

Dilaudid

HYDROCODONENovahistex DH

Novahistex DH

Expectorant

Novahistine DH

OXYCODONE

Percodan

percs

PENTAZOCINE

Talwin

Ts and Rs:

Talwin and

Ritalin

BUTALBITAL with

codeine, ASA and

caffeine Fiorinal-

C

ALPRAZOLAM

Xanax

Benzodiazepines

used primarily as

sleeping pills:

TEMAZEPAM

Restoril

FLURAZEPAM

Dalmane

TRIAZOLAM

Halcion

FLUNITRAZEPAM

Rohypnol

roofies, rope, the

forget pill

blue heavens

AMOBARBITAL-SECOBAR

BITAL

TuinalChristmas trees,

rainbows

ZOPICLONE

Imovane

Other Psychotropic Drugs

GHB

(gamma-

hydroxybutyrate)

liquid ecstasy, liquid x,

grievous bodily harm,

Scoop

3

STIMULANTS

4

CANNABIS

5

ANTIDEPRESSANTS

6

ANABOLIC STEROIDS

Stimulants (from the Latin

word stimulare, meaning "to

goad, torment, incite") are

Cannabis refers to the

preparations of the plant

Cannabis sativa (Latin

Antidepressants are

drugs designed to

treat clinical

Anabolic steroids act like

the male sex hormone

testosterone, and are


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drugs that produce a quick

temporary increase of energy.

Tobacco and caffeine are the

two most popular stimulants.

Cocaine has gained popularity

in recent years. Most of the

other drugs in this category

are amphetamines or

chemically-related substances.

COCAINE

C, coke, snow, flake, nose

candy, crack(a free-base form

of cocaine)Amphetamines:

DEXTROAMPHETAMINE

Dexedrine

dexies

METHAMPHETAMINE

Desoxyn

speed, crystal, meth, ice,

crank

METHCATHINONE

cat

KHAT

(Catha edulis)

qat, kat

Other:

METHYLPHENIDATE

Ritalin

DIETHYLPROPION

Tenuate

PHENTERMINE

Ionamin

TOBACCO

(Nicotiana tabacum)

CAFFEINE

for "cultivated hemp").

THC, a synthetic

preparation, the major

psychoactive ingredient

in cannabis preparations,

is also included in this

section.

MARIJUANA

(marihuana)

cannabis, pot, grass,

weed, reefer, ganja,

joint

HASHISH

hash

HASH OIL

oil, honey oil

THC

(tetrahydrocannabinol)

depression by

elevating mood.

Tricyclics:

AMITRIPTYLINE

Elavil

CLOMIPRAMINE

Anafranil

DESIPRAMINE

Norpamin

DOXEPIN

Sinequan

IMIPRAMINE

Tofranil

TRIMIPRAMINE

Surmontil

SSRIs:

FLUOXETINE

Prozac

VENLAFAXINE

Effexor

FLUVOXAMINE

Luvox

SERTRALINE

Zoloft

MAOIs:

TRANYLCYPROMINEParnate

PHENELZINE

Nardil

MOCLOBEMIDE

Manerix

known as ergogenic or

performance-enhancing

drugs.

OXYMETHOLONE

Anadrol-50

STANOZOLOL

Winstrol and Winstrol

V

NANDROLONE

Deca-Durabolin

METHANDROSTENOLONE

or METHANDIENONE or

METANDIENONE

Dianabol

OXANDROLONE

Anavar

BOLDENONE

Equipoise

METHENOLONE

METENOLONE

Primobolan

MESTEROLONE

Proviron

TESTOSTERONE

CYPIONATE

Depo-testosterone

TESTOSTERONE

ENANTHATE

Delatestryl

TESTOSTERONE

PROPIONATE

Testex

TESTOSTERONE

UNDECANOATE

Andriol

Top of Page


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Stimulants

Cannabis


8/38

Top of Page

1 HALLUCINOGENS

NAME DESCRIPTION ORIGIN

AND

MEDICAL

USES

SHORT-TERM EFFECTS

PCP

(phencyclidine)angel

dust, elephant, hog

Sold as powder of any

colour, in crystals, liquid,tablet, capsule or paste.

Frequently passed off as

LSD, THC, mescaline or

Originally

developedas an

intravenous

anaesthetic;

Effects of low to moderate doses

last 3 to 18 hours. Effects of highdoses may last for several days. It

can produce a state of pleasurable

intoxication, a sense of separation


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use. heart rate and blood pressure.

Higher doses produce distortions in

perception, thinking and memory,

hallucinations and, in some people,anxiety and depression. Deaths as

a result of kidney and/or heart

failure due to dehydration orhyperthermia have occurred in the

context of raves or dances.

Mescaline (3,4,5-

trimethoxybenze ne-

ethanamine), andany salts thereofPeyote

(Lophophora)

(3,4,5-

trimethoxyphen-

ethylamine)

Synthetic mescaline is a

white or coloured

powder; usually taken inform of powder, tablet,

capsule or liquid.

Common dose is 300 to500 mg, usually taken

orally. Organic or natural

mescaline is used to

describe the peyotebutton which usually

comes in capsule form,

but can also be chewedor ground up and

smoked. Of samples

analyzed at drug-testing

labs, nearly 90% turnout to be PCP, LSD or

some other substance.

Derived

from dried

buttons ofpeyote

cactus, or

synthesized.No

commonly

accepted

medicaluse.

Effects appear slowly, last 10 to 18

hours, and include changes in

perception and mood,disorientation, impaired short-term

memory and concentration.

Physical effects include dilation ofpupils, increased blood pressure

and heart rate, fever, sweating,

nausea and vomiting. High doses

can cause a headache.

Psilocybin, and any

salts thereof (occurstogether with

psilocin in somemushrooms) magic

mushrooms,

shrooms

Can be distributed as

mushrooms or incapsules containing

powder of any colour.

Can be sniffed, smoked

or injected. Powdermixed with fruit juice is

common form of

preparation. Commondose is anywhere from

1 mg to 20 mg, taken

orally. What is sold aspsilocybin usually turns

out to be PCP or LSD.

Active

ingredientsin several

species of

mushroom

and otherfungi that

grow

throughoutCanada; the

most

commonbelong to

the genus

Psilocybe.

Effects are felt after about half an

hour, last several hours, andinclude sensations of relaxation or

fatigue, separation from

surroundings, heaviness or

lightness. Larger doses produceperceptual distortions, dizziness,

abdominal discomfort, numbness of

the mouth, nausea, shivering,yawning, flushing and sweating.

There are no known deaths directly

caused by overdose, but drug-induced hazardous behaviours have

occurred in some individuals.

LONG-TERM

EFFECTS

TOLERANCE AND

DEPENDENCE

LEGAL STATUS

Flashbacks may

occur (see LSD

below). Othereffects include

persistent speech

problems,

Regular use may

produce tolerance.

Chronic usersmay become

psychologically

dependent. PCP

In Canada, phencyclidine, its salts, derivatives and

analogues and salts of derivatives and analogues are

governed by the provisions of the Controlled Drugs andSubstances Act applicable to Schedule I. Unlawful

possession is a criminal offence punishable on indictment

by imprisonment for up to seven years and on summary


11/38

depression,

anxiety or moresevere

psychological

consequences,

including toxicpsychosis, similar

to amphetamine

psychosis or acuteschizophrenia.

does not cause

physicaldependence.

conviction for a first offence to a fine of up to $1,000 or

imprisonment for up to six months, or both. Asubsequent offence is punishable on summary conviction

by a fine of up to $2,000 or imprisonment for up to one

year, or both. Trafficking, possession for the purpose of

trafficking, possession for the purpose of exporting,production, import and export are indictable offences

punishable by up to life imprisonment. (Peyote is not

covered by this Schedule.)

Decreased

motivation and

interest, or

prolongeddepression and

anxiety. LSD high

mayspontaneously

recur days, weeks

or even months

later (called"flashback"). Use

during pregnancy

may be related toincreased

incidence of

spontaneous

abortion or fetalabnormality.

After using LSD,

user must abstain

for several days

to regainsensitivity. This

tolerance crosses

over to mescalineand psilocybin.

Chronic users

may become

psychologicallydependent. LSD

does not cause

physicaldependence.

In Canada, these hallucinogens are governed by the

provisions of the Controlled Drugs and Substances Act

applicable to Schedule III. Possession is a criminal

offence punishable on indictment by imprisonment for upto three years and on summary conviction to a fine of

up to $1,000 or imprisonment for up to six months, or

both. A subsequent offence is punishable on summaryconviction by a fine of up to $2,000 or imprisonment for

up to one year or both. Trafficking, possession for the

purpose of trafficking, possession for the purpose of

exporting, production, import and export offences arepunishable on summary conviction by imprisonment for

up to eighteen months or on indictment by

imprisonment for up to ten years.

Some animalresearch indicates

repeated use cancause brain

damage.

Althoughinsufficient

research has beencarried out, it

seems that

tolerance to MDA

does not develop.Chronic users

may become

psychologicallydependent. MDA

is not known to

cause physical

dependence.

Regular use mayresult in

hangovers, weight

loss, exhaustion,flashbacks,

paranoia,

depression,

psychosis and liverdamage. Studies

in animals have

With repeateduse, tolerance

may develop.

Chronic usersmay become

psychologically

dependent. MDMA

is not known tocause physical

dependence.


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found evidence of

brain damage with

repeated or heavy

use

These drugs mayprecipitate

psychosis invulnerable users.

After usingmescaline or

psilocybin, usermust abstain fromboth for several

days to regain

sensitivity. This

tolerance crossesover to LSD .

Chronic users

may becomepsychologically

dependent.

Mescaline and

psilocybin are notknown to cause

physical

dependence.

1 HALLUCINOGENS (continued)


AND

MEDICAL

USES

SHORT-TERM EFFECTS

STP or DOM (2.5-dimethoxy-4-methylamphetamine)

Usually sold aswhite or off-whitepowder. Taken

orally, sniffed or

injected. Typicaldose is 3-l0 mg.

Producedin labsspecifically

for illegal

drugmarket. No

medical

use.

Effects may last 16 to 24 hours. Smalldoses produce mild euphoria,talkativeness and CNS stimulation;

higher doses produce LSD like effects

and can include exhaustion, confusion,excitement, dry mouth, nausea, blurred

vision, sweating, flushing and shaking.

Adverse reactions (bad trips) may result

in intense anxiety, panic and sometimespsychosis.

PMA (paramethoxy-

amphetamine)

Beige, white or pink

powder, usuallymisrepresented as

MDA.

Produced

in labsspecifically

for illegaldrug

market. No

medicaluse.

Effects are similar to MDA and Mescaline,

though far more toxic with excessive CNSstimulation including restlessness,

agitation, muscle contraction,hyperactivity, rigidity, racing pulse, high

blood pressure, increased and laboured

breathing, high fever, erratic eyemovement, muscle spasms and vomiting.

At moderate to high doses, PMA often

causes convulsions, coma and death.One of the most dangerous

hallucinogens.


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DMT, and any salts

thereof (N,N-

dimethyltryptamine)

Naturally occurring

in certain plants

found in SouthAmerica and West

Indies. Also

available in

synthetic form.

Usually parsley issoaked in solution

of DMT and thendried and smoked.

Typical dose is 50

to l00 mg. Can alsobe injected.

Produced

in labs

specificallyfor illegal

drug

market. No

medical

use.

Effects begin almost immediately, and

are similar to LSD, but last only one-half

to 4 hours, and include mood changesand increased sensitivity to bodily

sensations. At higher doses, can produce

hallucinations, dissociation and euphoria.

DMT may also produce anxiety and panic

states.

2CB or 2C-B or 2-CB (4-bromo-2,5-

dimethox

yphenethyl-amine

or -desmethyl DOBNexus, bromo,

toonies, herox,Synergy

In its pure form, itis a powder, but is

also available as

purple/red or white

pills and in yellowcapsules. Usually

swallowed, but itcan also be snorted.

It is readily

dissolved in water

or alcohol. Reporteddosage ranges from

5 mg to 30 mg

when swallowed,lower when snorted.

Syntheticchemical

first

synthesized

in the1970s.

Structurallysimilar to

DOM. Has

been sold

as MDMAand LSD.

No medical

use.

Effects have been likened to LSD, as wellas DOM and MDMA. If it is taken orally,

effects begin after one-half to 1 hour and

can last up to 4-8 hours. If snorted,

effects begin much more rapidly, withinabout 10 minutes and may last up to 1-

2 hours. At low doses, it producesintoxication, euphoria and visual

distortions. At higher doses, users report

that it produces visual distortions,

intense body awareness with increasedresponsivity to smells, tastes and sexual

stimulation. It may also produce nausea,

chills, trembling, cramps, muscle tensionand shallow breathing.

LONG-TERM

EFFECTS

TOLERANCEAND

DEPENDENCE

LEGAL STATUS

Insufficient

research.

It appears

that people

may rapidly

developtolerance to

the effects of

STP/DOM, butpsychological

and physical

dependence is

not known todevelop.

In Canada, these hallucinogens are governed by the provisions of

the Controlled Drugs and Substances Act applicable to Schedule III.

Possession is a criminal offence punishable on indictment by

imprisonment for up to three years and on summary conviction to afine of up to $1,000 or imprisonment for up to six months, or both.

A subsequent offence is punishable on summary conviction by a fine

of up to $2,000 or imprisonment for up to one year or both.Trafficking, possession for the purpose of trafficking, possession for

the purpose of exporting, production, import and export offences are

punishable on summary conviction by imprisonment for up to

eighteen months or on indictment by imprisonment for up to tenyears.

Insufficient

research.

Insufficient

research.

Insufficient

research.

Tolerance

does notdevelop and


14/38

there is no

evidence of

cross

tolerance toLSD. No

evidence of

psychologicalor physical

dependency.

Insufficient

research.

Insufficient

research.

Top of Page

2 CNS DEPRESSANTS

A. Opioid Analgesics

NAME DESCRIPTION ORIGIN ANDMEDICAL

USES

SHORT-TERM EFFECTS

Codeine Available astablets,

capsules, elixirs,

suppositoriesand solutions.

Often sold in

combination

product, e.g.,222, 292,

Tylenol withCodeine,Benylin Codeine

3.3 mg-D-E.

Constituent ofopium, used as

painkiller and

coughsuppressant.

Available only

with a

prescriptionexcept in low

doses incombinationwith analgesics

or in cough

syrups.

At low doses, as well as suppression of painand cough reflex, effects include dizziness,

light headiness, reduced mental alertness,

drowsiness, mild anxiety or euphoria. Athigher doses, effects include increased

sedation or euphoria, impaired concentration,

reduced respiration and blood pressure and

in some cases, rapid and irregular heart rate.Additional effects with overdoses can include

seizures, delirium, coma, respiratorydepression and fluid in the lungs.

Opium Dark brown

chunks orpowder. Can be

eaten or

smoked.

Used and

abused forcenturies.

Derived from

seed pod ofAsian poppy,

Papaversomniferum. No

current medicaluse for

unrefined

opium.

Effects include pain relief, euphoria, mental

clouding, sense of well-being, relaxation,drowsiness, nausea, contraction of pupils,

decreased urination, constipation, sweating,

itchy skin and slowed breathing. With verylarge doses, the pupils contract to pinpoints,

the skin is cold, moist, bluish, and breathingmay slow to a complete stop, resulting in

death.

Heroin use is particularly risky since purityand contents of dose can only be guessed.

Use in combination with alcohol can be very

dangerous.

When an opioid is injected intravenously, the

person feels a surge of pleasure, then a

state of gratification into which hunger, pain,sexual urges do not intrude. The body feels

Methadonedollies

Not marketedcommercially in

Canada, but can

be legally

Currently usedto treat people

dependent on

other opioids;

-


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for miscarriage, premature labour,

breech delivery, Caesarian section, and

low birthweight. Because opioids cross

the placenta, the infant may also beborn dependent and may suffer

withdrawal because of the mother's

use. However, the mother's withdrawalfrom opioids prior to birth can cause

stillbirth.

Dependence on opioids

taken in tablet or capsule

form (such as Percodan

or codeine) can goundetected by a person for

some time. People may

respond to discomfort ofwithdrawal by taking

another dose, withoutrealizing they have become

addicted.

both. Trafficking,

possession for the purpose

of trafficking, possession

for the purpose ofexporting, production

(cultivation of opium

poppy), import and exportare indictable offences

punishable by up to lifeimprisonment.

2 CNS DEPRESSANTS

A. Opioid Analgesics (continued)


AND

MEDICAL

USES

SHORT-TERM EFFECTS

OxycodonePercodan

percs

Available astablets.

Painkiller. As well as suppression of pain, effects may includedizziness, light headiness, reduced mental alertness,

drowsiness, mild anxiety and depression or euphoria,

contraction of pupils, blurred vision, nausea, vomiting,constipation, itchy skin. With high doses, effects include

increased sedation, impaired concentration, reduced

respiration and blood pressure, and in some cases, very

high doses may result in coma and death. Withoverdoses of products that contain acetylsalicylic acid

(ASA) use of very high doses may result in salicylate

intoxication, as well as opioid intoxication.

PentazocineTalwin Tsand Rs:

Talwin

and

Ritalin

Available astablets and

injectable

solution.

Painkiller. Produces similar effects to oxycodone. However higherdoses may produce changes in heart rate and blood

pressure and hallucinations/delusions, disorientation and

confusion. Respiratory depression is usually less severe

than with other opiods.

Butalbital

with

Codeine,ASA and

CaffeineFiorinal-C

Available as

tablets.

Painkiller. At low doses, produces state of relaxation, euphoria,

dizziness, drowsiness, mild impairment of motor and

cognitive functions and occasional vomiting, nausea andconstipation. At higher doses, may result in increased

central nervous system depression with effects similarto alcohol; very high doses may result in coma and

death. Both codeine and butalbital contribute to theseeffects. With overdoses of products that contain

acetylsalicylic acid (ASA), as well as an opioid, use of

very high doses may result in salicylate intoxication, aswell as opioid intoxication. Caffeine-containing products

used in high doses may result in caffeine intoxication.

LONG-TERM

EFFECTS

TOLERANCE AND DEPENDENCE LEGAL STATUS


17/38


18/38

The effects ofchronic high

doses of

butalbital with

codeine, ASA andcaffeine may be a

combination of

the effects of theindividual drugs

in this product -

see barbiturates,

codeine andcaffeine. Because

of the risk to the

developing fetus,this drug should

only be used by

pregnant women

in accordancewith physician

advice.

Because butalbital with codeine, ASAand caffeine is a combination product,

the development of tolerance and

dependence may vary greatly with

dosage and duration of use -seebarbiturates, codeine and caffeine for

further information on tolerance and

dependence.

Top of Page

2 CNS DEPRESSANTS B. Alcohol and Solvents/Inhalants


AND

MEDICAL

USES

SHORT-TERM EFFECTS

Alcohol (ethylalcohol or

ethanol)

In Canada, astandard drink

contains 13.6 g

or 17 mL ofabsolute alcohol.

This amount is

contained in a

12-ounce (341mL) bottle of

regular (5%)

beer, five ounces(142 mL) of

(12%) table

wine or 1.5ounces (43 mL)of 80-proof

liquor.

Definitions ofstandards drinks

are different in

other countries.

Can besynthesized

or produced

naturally byfermentation

of fruits,

vegetables

or grains.Although

some

physiciansmay

occasionally

recommendalcohol inmoderation,

this is not

commonmedical

practice.

Alcohol affects the central nervous system inproportion to the amount of alcohol in

bloodstream. Usual effects of small doses are

euphoria, drowsiness, dizziness, flushing,release of inhibitions and tensions. Larger

doses produce slurred speech, staggering,

double vision, stupor. Alcohol, even in fairly

low doses, impairs driving or the operationof complex machinery. In combination with

other drugs, small doses of alcohol may

produce exaggerated effects. A "hangover"with headache, nausea, shakiness and

vomiting may begin 8 to 12 hours after a

period of excessive drinking. Very largedoses can cause death by blocking thebrain's control over respiration.

Solvents/Inhalants

(volatile solvents)sniff

Inhalants are

found in manyhousehold and

With few

exceptions,these

Effects include feelings of euphoria, light-

headedness, exhilaration, vivid fantasies, andsometimes recklessness and feelings of


19/38

commercial

products such as

cleaning fluids,

fast-dryingglues, aerosols,

paint thinners

and removers.Inhalants also

include gasolineand other fuels,

anaestheticgases (e.g.,

nitrous oxide)

and somevasodilating

nitrites (e.g.,

amyl nitrite).

Most are poured

into a bag andinhaled, or

inhaled from a

saturated cloth

held over thenose. Aerosols

are inhaled

either directlyfrom can or by

spraying them

into a plastic

bag.

inhalants

have no

medical use.

Rather, theyare intended

for

commercialand

householduse.

invincibility. Depending on the type of

inhalant and method of use, possibly

irritation and watering of the eyes, sneezing,

coughing and nasal inflammation may occur.Inhalants enter the bloodstream from the

lungs and then go to other organs,

particularly the brain and liver. Breathing,heart beat and other body functions are

slowed down. If the person passes out with aplastic bag over the nose and mouth, death

from suffocation can occur. Death can alsooccur if the person is startled or engages in

strenuous activity while intoxicated. There

are also situational hazards such asexplosions, burns and aspiration of foreign

particles or objects into the lungs.

LONG-TERM EFFECTS TOLERANCE

AND

DEPENDENCE

LEGAL STATUS

Regular consumption ofmore than two drinks a

day may gradually bring

about liver damage, braindamage, heart disease,

certain types of cancer,

blackouts (loss ofmemory), impotence,

reproductive problems,

ulcers, and disorders ofthe pancreas. Chronicheavy use may result in

disruptions of the drinker's

social, family and workinglife. Consumption of

alcohol during pregnancy

may result in babies with

alcohol related pre andpostnatal developmental

and growth delays,

learning and behavioural

Regular useinduces

tolerance,

makingincreased doses

necessary to

produce desiredeffect. In the

case of chronic

use, people maydrink steadilywithout

appearing to get

drunk. Theircondition may

go unrecognized,

even by

themselves forsome time.

Chronic drinkers

are likely to

Offences relating to underage drinking includepossessing, consuming, purchasing, attempting to

purchase or otherwise obtaining liquor outside of

home. In some jurisdictions, parent or guardianmay legally supply liquor at home to an underage

person, but in others supplying liquor or selling

liquor to a minor is an offence. The age at whichyoung people are allowed to drink in Canada is

regulated by legislation and enforcement policy in

each province and territory. In the majority ofprovinces and territories, the drinking age wastwenty'one until the early seventies. Currently, in

all provinces and territories with the exception of

Quebec, Manitoba and Alberta, the drinking age is19 years. In Quebec, Manitoba and Alberta, the

drinking age is eighteen years. Though the trend

has been to lower the drinking age, several

provinces/territories first lowered and thenincreased their drinking age from 18 years to 19

years, for example, Ontario, PEI, and

Saskatchewan. It is an offence to drive with a


20/38

disorders, and other CNS

problems and physical

abnormalities. Since there

is no definite informationregarding a safe quantity

of alcohol use during

pregnancy, the prudentchoice for women who are

or may become pregnantis to abstain from alcohol.

become

physically and

psychologically

dependent.Withdrawal

symptoms may

range fromjumpiness,

sleeplessness,sweating,nausea and

vomiting, to

tremors,

seizures,hallucinations

and even death.

blood alcohol level (BAL) of .08% or greater, and

to drive while impaired even if one's BAL is less

than .08%. Many provinces/territories have

introduced 90-day administrative licencesuspensions to take effect almost immediately

after a driver registers a BAL over the statutory

limit or fails to provide a breath sample. In mostprovinces/territories, this limit is a BAL of .05%.

Effects include pallor,

fatigue, forgetfulness,

inability to think clearly,tremors, poor coordination

and difficulty walking,

thirst, weight loss,depression, irritability,

hostility, and paranoia.

Kidney, liver and braindamage may occur. It is

not known to what extent

the damage is reversible.

Simultaneous alcoholconsumption may

compound the damage.

Elevated blood-lead levelsand consequent brain

damage have been found

as a result of chronic

sniffing of leaded gasoline.

Regular use

induces

tolerance,making

increased doses

necessary toproduce the

desired effect.

Psychologicaland physical

dependence can

develop.

Withdrawalsymptoms

include anxiety,

depression,irritability,

dizziness,

tremors, nausea,

abdominal painsand headaches.

Inhalants are generally not controlled in Canada.

Inhalant abuse may be a factor taken into account

in dealing with young offenders and childrenfound in need of protection under provincial

legislation. In Alberta, inhaling or selling inhalants

to inhalers is illegal.

Top of Page

2 CNS DEPRESSANTS

C. Benzodiazepines

NAME DESCRIPTION ORIGIN AND MEDICALUSES

SHORT-TERM EFFECTS

Benzodiazepines Primarily

Used as Tranquilizers

(Anxiolytics)

Benzodiazepines were

introduced as

"tranquilizers" becausethey produce calm

without sleep, although

sleep may occur as a

result of relaxation andreduced anxiety. They

replaced barbiturates in

Effects include a feeling of well-being,

loss of inhibition, decreased muscle

tension, reduced mental alertnessand mildly impaired coordination and

balance. On rare occasions, and

usually at high doses, paradoxical

reactions such as rage, personalitychanges, sleep disturbances can

occur. Side effects such as skin

DiazepamValium


injectable

solution.


21/38

the treatment of many

disorders. They are

usually prescribed to

treat anxiety andnervousness, relax

muscles, control certain

types of muscle spasmand to treat sleep

problems. Although theyare safer and have fewer

side effects thanbarbiturates, they can

also produce dependence

and are generallyrecommended for

short'term use only.

rashes, nausea, dizziness have been

reported. Driving motor vehicles and

operating machinery should be

avoided by those taking tranquilizers.It is particularly hazardous to take

them together with alcohol, other

CNS depressants, and someantihistamines (in cold, cough and

allergy remedies). They are seldomfatal in overdoses except when mixed

with other drugs, especially alcohol.

OxazepamSerax


Lorazepam

Ativan

Available as

tablets and

injectablesolution.

AlprazolamXanax


Benzodiazepines Primarily

Used as Sleeping Pills

Temazepam

Restoril

Available as

capsules.

Benzodiazepines, used to aid sleep,

may produce morning and daytimedrowsiness and other "hangover"

effects.Flurazepam

Dalmane

Available as

capsules.

TriazolamHalcion


Flunitrazepam,

and any salts

or derivativesthereof

Rohypnol

roofies, rope,

the forget pill

Available as

tablets (but

tablets may becrushed to

yield a powder

which dissolves

more rapidly inliquids). Often

sold on the

street in"bubble" packs.

It is odourless,

colourless and

tasteless whenadded to

alcoholic ornon-alcoholicbeverages.

Although not approved

for general marketing as

a therapeutic drug inCanada or the U.S., it is

legally available in 64

countries in Europe, Latin

America, Africa and theMiddle East.

Mexico and other LatinAmerican countries are

the main illegal source of

supply for North America.Quantities of smuggled

Rohypnol have been

seized by the police inCanada. Its use has beenassociated with "date

rape" when it is added to

the victim's drink tolower inhibitions and

reduce memory of the

sexual assault.

Rohypnol is an extremely potent

benzodiazepine, which produces

drowsiness, dizziness, memory loss,muscle relaxation, impaired thinking

and motor coordination. It can also

produce aggressive behaviour. It is

absorbed very rapidly after oraladministration with effects occurring

after about 20 to 30 minutes. It has

been associated with data rapebecause it produces sedation and

memory loss. Also, because it is

odourless and tasteless, the victim

may have no idea that anything hasbeen added to his/her drink. The

amnesia produced by Rohypnol ("theforget pill") means a rape victim maynot remember the circumstances of

the sexual assault or how the drug

was taken. Combined with alcohol or

other CNS depressants, the effects ofRohypnol can be dangerously

increased.

LONG-TERM EFFECTS TOLERANCE AND

DEPENDENCE

LEGAL STATUS


22/38

Benzodiazepines

Some benzodiazepines which

are eliminated slowly (such as

diazepam) accumulate in bodytissues during sustained use.

Chronic abuse of

benzodiazepines may result in

impairment in thinking,memory and judgement,

confusion, disorientation, and

impaired motor coordination.Prolonged use may also lead to

increased, rather than reduced,

aggressiveness in some people.

When benzodiazepines areused by pregnant women, they

cross the placenta and are

distributed to the fetus. After

birth, babies exposed tobenzodiazepines in the uterus

may show withdrawalsymptoms. There is some

research evidence indicating an

increased risk of major

malformations and cleft palate.

Tolerance to the

sedative, but not

anxiety-relieving effectsof benzodiazepines can

develop with regular use

over a few months, as

can psychological andphysical dependence.

Stopping use abruptly

may result in symptomssuch as sleep

disturbances, headache,

tension, difficulty

concentrating, trembling,anxiety, and feeling

tired. During withdrawal

from very high doses,

there is a risk ofseizures, depression,

paranoia, agitation anddelirium. Withdrawal

symptoms may be

greater for

benzodiazepines that areeliminated rapidly from

the body.

In Canada, benzodiazepines and theirsalts and derivatives are governed by

the provisions of the Controlled Drugs

and Substances Act applicable toSchedule IV. Trafficking, possession

for the purpose of trafficking,

possession for the purpose of

exporting, production, import andexport offences are punishable on

summary conviction by imprisonment

for up to one year or on indictmentby imprisonment for up to three

years.

Like other

benzodiazepines, regular

use can induce tolerancemaking increased doses

necessary to produce

the desired effect.

Rohypnol is not approved for general

marketing as a therapeutic drug in

Canada. Flunitrazepam (Rohypnol) isgoverned by the provisions of the

Controlled Drugs and Substances Act

applicable to Schedule III. Possessionof Rohypnol is a criminal offence

punishable by imprisonment for up to

three years on indictment or uponsummary conviction to a fine of up to

$1,000 or six months imprisonment,

or both, for a first offence, and a fine

of up to $2,000 or up to one yearimprisonment, or both, for a

subsequent offence. Offences of

trafficking, possession for the purposeof trafficking, possession for the

purpose of exporting, production,

import and export of flunitrazepam

are punishable upon indictment byimprisonment for up to 10 years and

upon summary conviction by

imprisonment for up to eighteenmonths.

Top of Page


23/38

2 CNS DEPRESSANTS

D. Barbiturates/Other Sleeping Pills/Other Psychotropic Drugs

NAME DESCRIPTION ORIGIN AND

MEDICAL USES

SHORT-TERM EFFECTS

Barbiturates and Other Sleeping Pills

Secobarbital

Seconalreds, red birds,

red devils

Available as

capsules and

injectablesolution.

Barbiturates, also

called "downers", were

developed to treatsleep problems,

anxiety, tension, high

blood pressure andseizures. Some are

used as anaesthetics.

Barbiturates slow down the activity of

the central nervous system. Small

doses relieve tension; large dosesproduce drowsiness, staggering,

blurred vision, impaired thinking,

slurred speech, impaired perception oftime and space, slowed reflexes and

breathing, and reduced sensitivity to

pain. Overdoses can cause

unconsciousness, coma and death. Inthe past, many of the deaths due to

drugs (excluding alcohol) in Canadawere caused by barbiturates andbarbiturate-like drugs. Using

barbiturates with alcohol can be very

dangerous.

Pentobarbital

Nembutalyellow jackets

Available as

capsules and

injectablesolution.

AmobarbitalAmytalblueheavens

Available ascapsules,

tablets and

injectablesolution.

Amobarbital-

Secobarbital

TuinalChristmas trees,

rainbows

Available as

capsules.

Zopiclone

Imovane

Available as

tablets.

Other Psychotropic Drugs

GHB, and any

salts thereof

(gamma-hydroxybutyrate)

liquid ecstasy,liquid X,

grievous bodily

harm, Scoop

Usually

available as a

colourless,odourless and

tasteless liquid,but it is alsoavailable as a

powder or as a

capsule.

GHB was originally

developed as an

anaesthetic for itssedative rather than

pain-reducingproperties. It has alsobeen used in some

countries to treat

alcohol withdrawaland narcolepsy. In

England, it is

marketed as an anti-

aging drug. It has alsobeen used by body

builders to stimulate

muscle building

Effects of lower doses may include

lowered inhibitions, euphoria,

calmness progressing to drowsiness,dizziness and amnesia. Higher doses

may produce confusion,hallucinations, nausea, vomiting,diarrhea, tremors, combative and self-

injurious behaviours, seizures,

shortness of breath, loss ofconsciousness and coma. GHB is

currently circulating at dances and

raves, and is often used in

conjunction with alcohol, whichincreases the degree of disinhibition

and the risk of central nervous

system and respiratory depression.


24/38

growth hormones

during certain sleepcycles.

Can easily be made inlabs for illegal use.

GHB has been used to aid sexual

assaults on women.

LONG-TERMEFFECTS

TOLERANCE ANDDEPENDENCE

LEGAL STATUS

Long-term, high-doseuse may result in

effects similar to

chronic intoxication

(impaired vision,memory and

judgment, and slurred

speech), as well asdepression or mood

swings. Changes in

liver function may

result in fastermetabolism of other

drugs. Babies of

chronic users mayhave difficulty in

breathing and feeding,

disturbed sleeppatterns, sweating,

irritability and fever.

Regular use inducestolerance, making increased

doses necessary to produce

the desired effect. Tolerance

develops more quickly tothe mood-altering effects

than to the effects on the

respiratory system. Thus,the margin between an

effective dose and a lethal

dose gradually narrows.

Psychological dependencecan occur with regular use,

as can physical dependence.

Withdrawal symptomsincluding restlessness,

anxiety, insomnia, delirium,

seizures and may result indeath.

In Canada, barbiturates and their salts andderivatives are governed by the provisions

of the Controlled Drugs and Substances

Act applicable to Schedule IV. Trafficking,

possession for the purpose of trafficking,possession for the purpose of exporting,

production, import and export offences are

punishable on summary conviction byimprisonment for up to one year or on

indictment by imprisonment for up to

three years. Note: Zopiclone is currently

listed in Schedule F of the Food and DrugsAct.

Not enough evidence. Withdrawal symptoms havebeen reported after chronic

high-dose use.

GHB is governed by the provisions of theControlled Drugs and Substances Act

applicable to Schedule III. Possession ofGHB is a criminal offence punishable by

imprisonment for up to three years on

indictment or upon summary conviction toa fine of up to $1,000 or six months

imprisonment, or both, for a first offence

and a fine of up to $2,000 or up to one

year imprisonment, or both, for asubsequent offence. Offences of trafficking,

possession for the purpose of trafficking,

possession for the purpose of exporting,

production, import and export of GHB arepunishable upon indictment by

imprisonment for up to 10 years and upon

summary conviction by imprisonment forup to eighteen months.

Top of Page

3 STIMULANTS

NAME DESCRIPTION ORIGIN AND SHORT-TERM EFFECTS


25/38

MEDICAL

USES

CocaineC, coke, snow,

nose candy,

crack

Fine white crystalline powderoften diluted with sugar,

cornstarch, talcum powder or

with substances which imitateits numbing effects, such as

benzocaine. Can be sniffed,

smoked or injected. As well

as being sniffed through thenose, it can also be absorbed

through other mucous

membranes such as themouth. Typical dose levels

are 30-100 mg when sniffed;

injected doses may be lower

or higher, depending on thetolerance of the person.

"Crack" is a smokable,

freebase form of cocainewhich has become

increasingly available in

recent years. It is made by

adding baking soda to acocaine solution and allowing

the mixture to dry.

Derived fromleaves of South

American coca

bush. Practiceof sniffing

cocaine began

around turn of

the century,when it was

also consumed

in the form oftonics and

beverages. By

1911, cocaine

was legallyrestricted in

Canada. It is

still used as alocal

anaesthetic for

some surgery,

but has beenlargely replaced

by less toxic

substances.

Effects resemble those ofamphetamines with a shorter

duration. The person feels

euphoric, energetic, alert; has arapid heart beat and breathing,

dilated pupils, sweating, pallor,

and decreased appetite. Large

doses can cause severeagitation, paranoid thinking,

erratic or violent behaviour,

tremors, uncoordination,twitching, hallucinations,

headache, pain or pressure in

the chest, nausea, blurred

vision, fever, muscle spasms,convulsions and death.

Impurities in street cocaine may

produce a fatal allergic reaction.People may experience

depression, extreme tiredness

and stuffy nose as a "hangover"

from cocaine. The use of "crack"produces immediate and very

intense effects.

Amphetamines:

Dextro-amphetamine

Dexedrinedexies

Available as capsules andtablets. Can be taken orally,

smoked or injected.

Amphetamineswere developed

in the 1920s.

Used at first to

treat depressionand obesity,

but stringent

controls havegreatly reduced

medical use in

Canada. Used

in thetreatment of

narcolepsy,attention-deficithyperactivity

disorder

(ADHD) and

Parkinson'sDisease.

Produced

throughchemical

synthesis by

pharmaceutical

Effects include increasedalertness and energy, a feeling

of well-being, decreased

appetite, rapid heart beat and

breathing, increased bloodpressure, sweating, dilated

pupils, and dry mouth. A person

may become talkative, restless,excited, feel powerful, superior,

aggressive, hostile or behave in

a bizarre, repetitive fashion.

Very large doses produceflushing, pallor, very rapid or

irregular heart beat, tremors,severe paranoia, frighteninghallucinations. Death can result

from use as a consequence of

burst blood vessels in brain,

heart failure, very high fever.Violence, accidental or

otherwise, is the leading cause

of amphetamine-related deaths.

Meth-

amphetamineDesoxynspeed, crystal,

meth, ice,

crank

Available as a powder. Can be

taken orally, smoked orinjected.


26/38

companies and

illegal labs.

Methcathinone,

Cathinone and

any saltsthereofcat

White or off-white powder. It

can be snorted, taken orally

mixed with liquids such ascoffee or soft drinks, smoked

in crack pipes or mixed withtobacco or marijuanacigarettes or injected

intravenously. Usual dose is

100-250 mg, although doses

of 500 to 1000 mg used byintravenous injection or by

sniffing, have been reported.

Manufactured in

illegal

laboratoriesusing ephedrine

or pseudoephedrinemixed with a

number of

commercial

products suchas paint

thinners,

battery acidand lye. It has

been

manufactured

illegally in theU.S. since

1989. Illegal

manufacturehas been

associated with

biker gangs.

Potent stimulant with effects

similar to crack cocaine or

methamphetamine with effectslasting 4-6 hours. May be used

in binges over a period ofseveral days. At low doses,effects include euphoria,

increased alertness, increased

heart rate, respiration and blood

pressure, loss of appetite,dilated pupils. At higher doses,

sleeplessness and agitation,

tremors and muscle twitching,irregular heart rate and

respiration, paranoia,

hallucinations and delusions,

aggressive behaviour, andseizures can occur. Deaths have

been reported.

Khat, its

preparations,derivatives,

alkaloids and

salts (Cathaedulis) qat, kat

Leaves of Khat plant are

chewed. Leaves must be freshas they dry out and lose they

potency after picking. The

active ingredient of Khat is"cathinone", closely related to

amphetamine. Higher

concentrations are found in

young plants.

Grown in East

Africa andArabian

Peninsula where

it is used as arecreational

drug and in

some countries

such as theYemen, it is

used as part of

formal socialoccasions. No

known medical

uses.

Effects last 3-4 hours and

include, at lower doses,euphoria and elation, increased

energy and alertness, loss of

appetite and insomnia,increased heart rate and blood

pressure, respiration and body

temperature, decreased sexual

drive, increased aggression andfantasies of personal

supremacy. At higher doses,

effects include constipation,paranoia, psychotic episodes,

very aggressive behaviour, as

well as risk of brainhaemorrhage, heart attack and

pulmonary edema.


DEPENDENCE

LEGAL STATUS

High-dose, chronic users, who

alternate cocaine "binges" with

crashes (periods of abstinence)

may show mood swings,restlessness, extreme

excitability, restlessness, sleep

disorders, suspiciousness,

Chronic use results in

tolerance. Cocaine can

produce very powerful

psychologicaldependence leading to

extremely compulsive

patterns of use. In

In Canada, cocaine is governed by the

Controlled Drugs and Substances Act

applicable to Schedule I. Unlawful

possession is a criminal offencepunishable on indictment by

imprisonment for up to seven years and

on summary conviction for a first offence


27/38

hallucinations and delusions,

eating disorders, weight loss,constipation and impotence.

Characteristic signs of chronic

cocaine sniffing are stuffiness

and runny nose, chappednostrils, perforation of nasal

septum. Cocaine abuse is also

associated with cardiacarrhythmias, myocardial

infarctions, strokes, seizures

and sudden deaths. People

who inject cocaine are at riskfor HIV and hepatitis.

Heavy use of cocaine bypregnant women is associated

with reduced fetal weight and

an increased risk ofmiscarriage, stillbirth,

premature birth and

malformation. Newborns

exposed to cocaine in theuterus may also experience

abnormal sleep patterns, poor

feeding and irritability forseveral days or weeks after

birth.

particular, the

dependency-producingproperties of cocaine

are believed to be

more powerful than

any otherpsychoactive drug.

Physical dependence

may also develop.Withdrawal symptoms

may include fatigue,

long but disturbed

sleep, strong hunger,irritability, depression,

violence.

to a fine of up to $1,000 or

imprisonment for up to six months, orboth. A subsequent offence is punishable

upon summary conviction by a fine of up

to $2,000 or imprisonment for up to one

year, or both. Trafficking, possession forthe purpose of trafficking, possession for

the purpose of exporting, production

(cultivation of Erythroxylon coca), importand export are indictable offences

punishable by up to life imprisonment.

Chronic heavy users may

develop malnutrition and

amphetamine psychosis, a

mental illness similar toparanoid schizophrenia. They

may be prone to violence.Impurities injected with the

drug can block or weaken

small blood vessels. Kidneydamage, lung problems, stroke

or other tissue injury can

result. Instances of withdrawal

symptoms among newborninfants of mothers using

amphetamines have been

reported.

Although chronic use

results in tolerance to

the mood-elevating

effects ofamphetamines,

tolerance does notappear to develop to

the beneficial effects

in treatment ofattention-deficit

hyperactivity disorder

or narcolepsy. Like

cocaine,amphetamines can

produce very powerful

psychological

dependence leading tocompulsive patterns of

use.

Although major

physical signs of

withdrawal do notoccur after chronic

high-dose users

abruptly discontinueamphetamine use,

they may experience

extreme fatigue and

In Canada, amphetamines and their

salts, derivatives and analogues are

governed by the provisions of the

Controlled Drugs and Substances Actapplicable to Schedule III. Possession is

a criminal offence punishable onindictment by imprisonment for up to

three years and on summary conviction

to a fine of up to $1,000 orimprisonment for up to six months, or

both. A subsequent offence is punishable

on summary conviction by a fine of up

to $2,000 or imprisonment for up to oneyear, or both. Trafficking, possession for

the purpose of trafficking, possession for

the purpose of exporting, production,

import and export offences arepunishable on summary conviction by

imprisonment for up to eighteen months

or on indictment by imprisonment for upto ten years.


28/38

prolonged but

disturbed sleep, and

subsequently,

irritability, tirednessand depression.

Insufficient research. Khat is believed to

cause at leastpsychologicaldependence and

prolonged use may

result in withdrawal

symptoms such aslethargy, depression,

nightmares and

tremors.

In Canada, Khat is governed by the

Controlled Drugs and Substances Act,applicable to Schedule IV. Trafficking,possession for the purpose of trafficking,

possession for the purpose of exporting,

production, and import offences are

punishable on summary conviction byimprisonment for up to one year or on

indictment by imprisonment for up to

three years.

Top of Page

3 STIMULANTS (continued)


AND

MEDICAL

USES

SHORT-TERM EFFECTS

Other:

Methylphenidate

and any salts

thereof Ritalin

Available as tablets. Used to

treat

narcolepsy

and childrenwith

attention-

deficithyperactivity

disorder

(ADHD).

An adult who uses high doses

may experience increased

alertness and energy, feeling

of well-being, nervousness,insomnia, decreased appetite,

rapid heart beat and

breathing, increased bloodpressure, sweating, dilated

pupils, dry mouth. A person

may become talkative,restless, excited, feel

powerful, superior, aggressive,

hostile or behave in a bizarre,

repetitive fashion. Very largedoses produce flushing, pallor,

very rapid or irregular heart

beat, tremors, severeparanoia, frightening

hallucinations. Death can

result from use as a

consequence of burst bloodvessels in the brain, heart

failure, or very high fever.

Violence, accidental orotherwise, is the leading cause

of amphetamine-related

deaths.

In children with ADHD,

Diethylpropion,

and any saltsthereof

Tenuate

Available as tablets. Limited use

as an aid intreating

obesity.

Phentermine,

and any saltsthereof

Ionamin

Available as capsules.


29/38

methylphenidate's effects

include decreased

hyperactivity, decreased

impulsiveness, increasedattention span, and more

controlled activity. However,

these effects may not beevident until some time after

treatment has begun.Unwanted effects may includeinsomnia, decreased appetite,

headache and dizziness. Some

growth retardation has been

reported in small numbers ofchildren treated over long

periods with methylphenidate.

Tobacco

(Nicotiana

tabacum)

Shredded, cured (dried) leaves of

the tobacco plant, which can be

smoked in cigarettes, cigars orpipes, or chewed, or inhaled. New

regulations will require

manufacturers to display healthwarnings, health information and

toxic constituent information on

packages of all tobacco products.The health warnings will occupy

50 percent of the package and

will include graphic images of the

consequences of tobacco use.New regulations will also require

manufacturers to collect and

report on 43 of the over 4,000chemicals found in tobacco

smoke. Of these, tar, nicotine,

carbon monoxide, benzene,

formaldehyde and hydrogencyanide will be listed on the

package with a range of

emissions, depending uponsmoking patterns.

Discovered

among

Northernand Central

American

tribes during16th

century.

There is nocurrent

medical use

for tobacco.

However,nicotine, the

main

psychoactivecomponent

of tobacco,

is an active

ingredient innicotine

"gum" and

nicotine"patches",

used as aids

to assist

smokers toquit

smoking.

Effects include increased heart

rate and blood pressure, drop

in skin temperature, fasterbreathing, and decreased

appetite. First -time smokers

may feel dizzy and energizedand may experience diarrhea

and vomiting. Tar accumulates

in the lungs. Inhaling smokerssubject themselves to very

high carbon monoxide levels.

They also subject people

around them to smoke effects.Two or three drops of pure

nicotine, the plant's most

potent ingredient, may rapidlykill an adult. A single cigarette

puts about 1-2 mg of nicotine

into the bloodstream of the

15-20 mg found in tobacco.When eaten, nicotine is

absorbed slowly in stomach,

which is why small childrensometimes survive after eating

cigarettes.

Caffeine White bitter-tasting crystalline

substance found in coffee beans,tea leaves, cacao leaves and kola

nuts. Available in tea, coffee,

chocolate, cola drinks,

medication. The caffeine contentof coffee and tea used as

beverages depends upon the type

of brew or leaves used in

Caffeine is

aningredient in

many

prescription

and non-prescription

pain

relievers,

Effects include mild mood

elevation and reduceddrowsiness and fatigue.

Caffeine shortens sleep,

stimulates secretion of

stomach acid, decreasesappetite, causes hand-tremor,

and impairs fine coordination

of movement, increases


30/38

preparation, and the manner of

preparation. In one study, a cupof instant coffee was found to

contain about 66 mg of caffeine,

percolated 74 mg, and drip

112 mg, and a cup of teaaveraged 27 mg. Cola drinks

contain about 35 mg per can

(280 mL); chocolate bars containas much as 20 mg. Caffeine in

most headache remedies, pain

relievers, cold remedies and

stimulant mixtures is between15-50 mg. Non-prescription

medications to help in staying

awake may contain considerablyhigher levels of caffeine.

cold

remediesand stay-

awake

remedies.

Coffee wasintroduced

into Europe

from Africasome 1,000

years ago.

metabolic rate, blood

pressure, urination and bodytemperature. Large doses of

caffeine can produce

headaches, nervousness,

irritability, restlessness,agitation, rapid and irregular

heart rate and delirium. Fatal

dose of the pure substance isabout 3.5 g taken

intravenously or about 10 g

taken orally.


DEPENDENCE

LEGAL STATUS

Chronic heavy users may developmalnutrition or amphetamine psychosis,

a mental illness similar to paranoid

schizophrenia. They may be prone toviolence. If these tablets and capsules

are used to prepare injectable mixtures,

people are at risk from both infections

from use of unsterile needles, syringesand other paraphernalia, and damage to

kidney, lung and brain as a result of

tablet particles entering the

bloodstream.

Chronic use results intolerance to the

euphoric and appetite

suppressant effects,although tolerance

does not appear to

develop to the

beneficial effects whenused therapeutically

to treat disorders

such as attention-

deficit hyperactivitydisorder or

narcolepsy. Regular

use of amphetamine-type drugs at high

doses can produce

very powerfulpsychological

dependence and

extremely compulsive

patterns of use.Withdrawal symptoms

include fatigue, long

but disturbed sleep,hunger on awakening,

irritability, depression

and violence.

Methylphenidate is governedby the provisions of the

Controlled Drugs and

Substances Act applicable toSchedule III. Possession is a

criminal offence punishable on

indictment by imprisonment

for up to three years and onsummary conviction to a fine

of up to $1,000 or

imprisonment for up to six

months, or both. A subsequentoffence is punishable on

summary conviction by a fine

of up to $2,000 orimprisonment for up to one

year or both. Trafficking,

possession for the purpose oftrafficking, possession for the

purpose of exporting,

production, import and export

offences are punishable onsummary conviction by

imprisonment for up to

eighteen months or onindictment by imprisonment

for up to ten years.

These drugs and their salts

and derivatives are governed

by the provisions of theControlled Drugs and

Substances Act applicable to

Schedule IV. Trafficking,possession for the purpose of


31/38

trafficking, possession for the

purpose of exporting,

production, import and export

offences are punishable onsummary conviction by

imprisonment for up to one

year or on indictment byimprisonment for up to three

years.

Stimulant medications used to

treat obesity are tightly

controlled.

Tar is a complex mixture of particlesfound in tobacco smoke. It has been

identified as causing cancer in smokers.

An average smoker who consumes 20

cigarettes per day can inhale between 1and 140 gm per year, depending upon

the cigarette smoked and how it issmoked. Much of this is coughed up inphlegm. Possible effects of smoking

include cancer of the lungs, mouth and

throat, respiratory disease, heart attack,

stroke and stomach ulcers. Smokingincreases blood pressure, depletes

Vitamin C levels, causes skin wounds to

heal more slowly, and reduces immunityto disease. Research indicates that each

cigarette cuts 5.5 minutes from smoker's

lifespan. The babies of women who

smoke tend to weigh less at birth thanthose of nonsmokers; the risk of

prematurity, miscarriage and stillbirth is

greater. Studies suggest that themother's smoking can have a

detrimental effect on the child's growth,

intellectual development and behaviour.

Second-hand smoke (passive smoking)

increases the risk of lung cancer and

heart disease in nonsmokers. Childrenwhose parents smoke have more ear

infections, more chest infections and

other lung problems, such as asthma,than children of nonsmokers. Second-

hand smoke is a special problem for

allergic people and those with heart orlung disease.

Most smokers arephysically and

psychologically

dependent. Those who

quit early mayachieve the same

health levels asnonsmokers after afew years, although

some damage may

not be completely

reversible.

The Federal Tobacco Act sets18 as the minimum age at

which retailers may furnish

tobacco products to youth.

Some provinces, notably NovaScotia, New Brunswick,

Newfoundland, Ontario andBritish Columbia, have set thisage limit at 19. In addition,

because it can harm the non-

smoker in a variety of ways,

from irritation to death, manymunicipalities and provinces

have enacted by-laws that

restrict or ban smoking inpublic places, including

restaurants and bars. At the

federal level, the Non-

Smokers' Health Act banssmoking in all federally-

regulated workplaces and bans

smoking on trains, planes,buses and ships.

Regular use of more than 600 mg a day(eight cups of coffee) can cause chronic

insomnia, persistent anxiety and

depression, stomach upset. Heavy use ofcaffeine should be avoided during

pregnancy since recent research has

Regular consumptionof 350 mg or more of

caffeine a day (two to

four cups of coffee)may lead to a form of

physical dependence.

Although there are no laws inCanada governing the

distribution or use of caffeine

in foods, caffeine-containingdosage forms offered for sale

or sold in Canada must comply


32/38

identified possible links between heavy

use and birth problems.

Abruptly stopping use

of caffeine-containingbeverages may result

in withdrawal

symptoms including

severe headache,irritability and fatigue.

with the Food and Drugs Act

and Regulations respectingcontent, labelling, etc.

Violation of the Act or

Regulations is an offence

punishable on indictment by afine of up to $5,000 or by

imprisonment for up to three

years, or both, and onsummary conviction for a first

offence by a fine of up to

$500 or imprisonment for up

to three months, or both, andfor a subsequent offence to a

fine of up to $1,000 or

imprisonment for up to sixmonths, or both.

Top of Page

4 CANNABIS

NAME DESCRIPTION ORIGIN AND MEDICAL

USES

SHORT-TERM EFFECTS

Marijuana(marihuana)

cannabis, pot,

grass, weed,

reefer, ganja,joint

Flowering topsand leaves of

the cannabis

plant. Ranges

in colour fromgrey-green to

greenish-

brown; intexture, it

resembles

oregano orcoarse tea. It

usually

contains seeds

and stems. Ithas a strong

odour and is

smoked in apipe or hand-

rolled

cigarette.

There aregreater

concentrations

of the activeingredient,

THC, now than

in the past.

Obtained from the plantCannabis sativa, which grows

in almost any climate. In the

past, most Cannabis products

found in Canada were grownin South and Central

America. Now much is grown

locally, some underhydroponic conditions. THC

(delta-9

tetrahydrocannabinol) andother cannabis constituents

have been claimed in

anecdotal reports to relieve

symptoms associated withthe following medical

conditions: nausea and

vomiting, wasting syndrome,multiple sclerosis, epilepsy

and glaucoma. THC

chemically synthesized is

marketed as Marinol(dronabinol) and Cesamet

(nabilone), a synthetic

cannabinoid, are both usedorally to treat nausea and

vomiting resulting from

chemotherapy. The treatment

of AIDS-related anorexiaassociated with weight loss is

another approved use of

Marinol dronabinol .

Effects of smoking are feltwithin a few minutes and last

two to four hours. Effects

from ingestion (e.g., eaten in

baked or cooked foods)appear more gradually and

last longer, and the person

may feel dull and sluggish forsome time afterwards. The

person feels calm, relaxed,

talkative and sometimesdrowsy. Concentration and

short-term memory are

markedly impaired, and

sensory perception seemsenhanced, colours are

brighter, sounds are more

distinct, and the sense of timeand space is distorted.

Appetite increases, especially

for sweets. Some people

withdraw, or experiencefearfulness, anxiety,

depression; a few experience

panic, terror or paranoia,particularly with larger doses.

Some experience

hallucinations with larger

doses and symptoms worsenin persons with psychiatric

disorders, particularly

schizo hrenia.

Hashish hash Dried, sticky

resin of


33/38

Cannabis plant.

Sold in solid

pieces, ranging

in colour fromlight brown to

black; in

texture fromdry and hard

to soft andcrumbly.Usually

crumbled and

smoked in pipe

or hand-rolledcigarette with

tobacco or

marijuana.People who use

heavily may

use from 0.25

-1 gdaily. Itcan be baked

into cookies or

cakes.

Physical effects include

impaired coordination andbalance, rapid heartbeat, red

eyes, dry mouth and throat.

Usual doses impair motor

skills; especially when used incombination with alcohol;

cannabis use before driving isparticularly dangerous. THC,the active ingredient, has

been detected in many bodies

of fatally-injured drivers and

pedestrians in Canada and theUnited States.

Hash Oil oil,honey oil

Thick,greenish-black,

reddish-brown

or yellow oil,

obtained byextracting

hashish with

an organicsolvent.

Usually wiped

onto a

cigarette orrubbed into

tobacco and

smoked.

Hash oil is

much morepotent than

other forms of

cannabis andonly a smallamount is

required to

achieve aneffect.

THC

(tetrahydrocanna-

binol)

Active

ingredient in

cannabis. Pure,

synthetic THCis seldom


34/38


35/38

cannabis marijuana is punishable by

imprisonment for up to seven years.

Possession for the purpose of export, import

and export of any quantity of cannabis plant,cannabis marijuana, cannabis resin, hash oil,

or other constituent of the cannabis plant or

other preparations, derivatives or similarsynthetic preparations is an indictable offence

punishable by up to life imprisonment.

Top of Page

5 ANTIDEPRESSANTS

NAME DESCRIPTION ORIGIN AND MEDICAL USES SHORT-TERM EFFECTS

Tricyclic Antidepressants There are three broad categoriesof antidepressants: Tricyclics,

Monoamine oxidate inhibitors

(MAOIs) and Selective serotoninreuptake inhibitors (SSRIs).Tricyclic antidepressants and

MAOIs were introduced in the

1950s. The tricyclicantidepressants have been the

most widely used type of

antidepressant drugs, but themore recently introduced SSRIs

have fewer side effects and are

less dangerous if an overdose is

taken. Antidepressants areprimarily prescribed to treat

clinical depression, but also usedto treat chronic pain, severeanxiety syndromes, obsessive-

compulsive disorders and

bulimia. It is believed that

antidepressants lift mood byworking on several types of

neurons and their

neurotransmitters such asserotonin and norepinephrine

which stimulate brain activity.

Some antidepressants work by

blocking the reuptake of theseneurotransmitters (Tricyclics and

SSRIs); others work by blocking

the action of enzymes that breakdown the neurotransmitters

(MAOIs).

Antidepressants take about2 to 6 weeks to elevate

mood. Side effects from the

antidepressant medicationcan include dry mouth,drowsiness and fatigue,

dizziness, blurred vision,

sweating, drop or rise inblood pressure (depending

upon the specific drug),

muscle tremors or twitching,changes in libido or sexual

performance and

nightmares. Care should be

taken when driving a car oroperating machinery. They

should not be combinedwith alcohol or other centralnervous system depressant

drugs, as combined use can

potentiate central nervous

system depressant effectsresulting in excessive

drowsiness, impaired

coordination, confusion andincreased risk of falls. As

well as general side effects,

the different types of

antidepressants may haveunique side effects, such as

the need to follow a special

diet with the older MOAinhibitors.

AmitriptylineElavil


oral liquid.

Clomipramine

Anafranil

Available as

tablets.

Desipramine

Norpramin

Available as

tablets.

DoxepinSinequan Available ascapsules.

Imipramine

Tofranil

Available as

tablets.

Trimipramine

Surmontil

Available as

tablets and

capsules.

Selective Seratonin ReuptakeInhibitors (SSRIs)

Fluoxetine

Prozac

Available as

capsules and

oral solution.

Venlafaxine

Effexor

Available as

tablets andcapsules.


36/38

Fluvoxamine

Luvox

Available as

tablets.

Sertraline

Zoloft

Available as

capsules.

Monoamine Oxidase

Inhibitors (MAOIs)

TranylcypromineParnate


Phenelzine

Nardil

Available as

tablets.

Moclobemide

Manerix

Available as

tablets.

TOLERANCE AND

DEPENDENCE

LEGAL STATUS

Tolerance does not

appear to develop for

antidepressants.However, mild

withdrawal symptoms

may be experienced

upon stopping usesuddenly, thus their

use should bereduced slowly over a

one- to two-month

period.

All of the tricyclics, MAOIs and SSRI antidepressants are subject to the

provisions of the Food and Drugs Act and Food and Drug Regulations

applicable to drugs listed in Schedule "F" to the Regulations. TheRegulations generally require that the sale or distribution of Schedule "F"

drugs be made pursuant to a prescription. Violation of the Act or

Regulations is an offence punishable upon indictment by a fine of up to

$5,000 or imprisonment for up to three years, or both, and uponsummary conviction for a first offence by a fine of up to $500 or

imprisonment for up to three months, or both. A subsequent offence ispunishable by a fine of up to $1,000 or imprisonment for up to six

months, or both.

6 ANABOLIC STEROIDS

NAME DESCRIPTION ORIGIN AND

MEDICAL USES

SHORT-TERM EFFECTS

OxymetholoneAnadrol-50

Taken orally,for human use.

Anabolic steroids, alsoreferred to as

androgenic anabolic

steroids, belong to a

group of drugs knownas ergogenic or

performance enhancing

drugs. They includeboth the naturally

occurring male sex

hormone, testosterone

and its precursors, and

Synthetic anabolic steroids aredesigned to mimic the body

building properties of

testosterone. These drugs

increase lean muscle mass,strength and endurance but no

scientific studies support their

"performance-enhancing effects";they have not been found to

improve agility, skill.

cardiovascular capacity or

recovery.

StanozololWinstrol &

Health Canada Drug Abuse.pdf

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